青少年母亲所生婴儿的死亡率及其危险因素

目的 :描述 1980～ 2 0 0 0年美国内华达州青少年母亲所生婴儿死亡率和变动趋势 ,并探索婴儿死亡的危险因素。方法 :利用 1980～ 2 0 0 0年内华达州出生 /死亡登记数据库资料进行分析。共有 42 1964名出生登记资料 ,包括 5 5 419名10～ 2 0岁青少年母亲所生婴儿登记资料。利用多因素Logistic回归模型分析婴儿死亡的危险因素和联系强度。结果 :该州1980～ 2 0 0 0年青少年母亲所生婴儿的死亡率变动范围为 5 .69～ 14 .72 /10 0 0 ,年平均死亡率为 9.5 1/10 0 0 ,显著高于 2 0岁及以上母亲所生婴儿的死亡率 ( 6.14 /10 0 0 )。婴儿死亡率在1980～ 2 0 0 0年间总体呈下降趋势。黑种人母亲的婴儿死亡率最高 ,为 16.0 7/10 0 0 ,显著高于白种人、本土美国人、亚裔和其他种族人。婴儿死亡率总体随着出生时母亲的年龄增长而下降 ,母亲 13～ 16岁时 ,随年龄降低明显 ;16岁以后缓慢降低 ,并维持在一定水平 ,40岁以后又显著上升 ;提示母亲年龄 16岁可能是一个重要的切割点。本研究同时得出 ,先天性畸形足、Meconiumaspirationsyndrome、先天性心脏畸形、RepeatC section、辅助通气少于 3 0min、出生体重、母亲吸烟、母亲产前护理开始时间等因素与婴儿死亡呈显著正关联 ,OR分别为 2 4.2 5、10 .68、10 .2 3、4.73、

Mortality and Other Risk Factors among Infants Born to Teenage Mothers

Objective:To describe the profiles and changing tendency of infant mortality born to teenage mother in the state of Nevada, 1980-2000, and explore the risk factors of infant mortality. Methods: The Nevada Linked Birth/Infant Death data sets in 1980-2000 was analyzed. Total of 421 964 live births were registered, which included 55 419 live births born to teenage mother aged 10- 20 years old. Multivariate binary logistic regression model was used to explore the risk factors of infant mortality and estimate the strength of association. Results: Infant mortality rate (IMR) born to teenage mother varied from 5.69 to 14.72 per 1 000 live births in 1980-2000, mean IMR was 9.51 per 1 000 live births during these 21 years, which were higher than IMRs born to 20 years or older mothers every year. IMRs in two groups seem to have an overall decline by year during this period. The infant mortality rate born to black teenage mother reached to 16.07 per 1 000 live births, which was the highest one and significantly higher than those born to white, native American, Asian and other race mothers. Infant mortality rate generally appeared to decline by the increase of mothers age and 16 years old should be an important cut point. This study showed that Congenital anomalies: Club foot, Abnormal conditions of newborn: Meconium aspiration syndrome, Congenital anomaly: Heart malformation, Method of delivery: Repeat C-section, Abnormal conditions of newborn: Assisted ventilation < 30 min, Birth weight group, Tobacco use, The time mother prenatal care began were significantly positively associated with infant mortality born to teenage mothers, their odds ratios were 24.25, 10.68, 10.23, 4.73, 2.49, 2.00, 1.99 and 1.19 respectively. The clinical gestation estimates was significantly negatively associated with infant mortality as odds ratio of 0.79. Conclusion: Infant mortality born to teenage mother is one of important public problem in Nevada, there are different risk factors related to infant death born to teenage and adult mother. Teenage pregnancy and its outcome should be paid more attention to study.